Much more than a tremor…
One of the biggest misconceptions about Parkinson’s is that it’s ‘just a tremor’ — so this week we’re taking a closer look at some other important aspects of the condition and the latest research advances.
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Tremor or shaking, especially affecting the hands, is probably the most well known and obvious symptom of Parkinson’s.
But…
Not everyone with Parkinson’s has a tremor. One study of 100 people with Parkinson’s showed that 68 had tremor at diagnosis, 75 experienced it during the course of the condition, and 9 lost their tremor later on.
Not everyone with a tremor has Parkinson’s. People can be shaky for many reasons — one of the most common being a condition called Essential Tremor which is much more common than Parkinson’s.
And people tell us that tremor is often the least of their problems. When we worked with people affected to understand research priorities for improving everyday life, developing treatments to address tremor was 26th on the list (of 26). Find out more about our priority setting partnership.
So, in this blog we’re shining a light on some of the less well known aspects of the condition, and the vital research being done to tackle these problems.
Falls
Loss of balance and falling affects many people with Parkinson’s and the problem tends to increase over time. Falls are one of the major reasons that people with Parkinson’s are admitted to hospital, and fear of falling can prevent people from getting out and about, which can have a huge impact on independence, social relationships and physical activity.
When we asked people affected by Parkinson’s what their priorities were for improving everyday life, ‘balance and falls’ emerged as the number one issue that they wanted research to address.
What research is being done?
A team at the University of Newcastle is studying when and why people fall. They have found that falls are common, even in the early stages of Parkinson’s, and believe that finding ways to predict falls could be key to preventing them and keeping people active and independent.
Find out more by watching the video below:
Other research offers hope that drug treatments could help. A recent clinical trial, funded by Parkinson’s UK, suggested that a drug that is currently used to improve attention and thinking for people with dementia (called rivastigmine) may be helpful for improving balance and walking, and could help to prevent falls.
Dr Emily Henderson, who led the study, explains more in the video below.
Freezing
More than a third of patients with Parkinson experience freezing, which many describe as like their feet getting ‘glued to the ground’. While walking, people can suddenly lose the ability to lift their feet and can become stuck in place for several seconds or even minutes despite their efforts to continue.
We don’t fully understand what causes people with Parkinson’s to freeze. However, problems with the way the brain processes visual information from the environment and how it uses that information to plan movements both seem to be involved in freezing.
What research is being done?
Researchers are developing strategies to help people who experience freezing…
Music can help. Research studies have shown that listening to music with a strong rhythm, such as marching music, can help to overcome freezing. Scientists believe the music acts like a metronome and helps people to maintain a steady tempo to their walking.
And so can visuals. Other studies, like this one, have shown that visual prompts — like lines drawn on the floor — can also be a helpful strategy against freezing. And we’re currently funding research to explore these coping strategies further.
Constipation
People with Parkinson’s are more likely to experience constipation — infrequent and/or difficult to pass stools — than the general population.
Severe constipation can cause abdominal pain and make people feel unwell, tired and nauseous. It can also interfere with the absorption of Parkinson’s medication which can lead to symptoms getting worse.
What research is being done?
Research has shown that constipation is an issue that often occurs before the main movement symptoms of Parkinson’s appear and that there may be important changes in both the bacteria that live in the gut and the nerve cells that connect the gut to the brain. Read more about this in our recent blog.
As a result, the gut is now a hot topic in Parkinson’s research. Researchers are now studying gut sample biopsies from people with and without Parkinson’s and investigating exactly what is happening to gut bacteria. Recent studies have offered hope that developing treatments that target gut bacteria could provide a route to new treatments.
In addition to this there are also studies underway around the world exploring possible avenues to better therapies to tackle constipation, including probiotics and drug treatments.
Pain
Many people with Parkinson’s experience pain as part of the condition which can be extremely debilitating.
What research is being done?
Some research suggests that pain in Parkinson’s is mainly caused by the physical symptoms of the condition — like joint stiffness and muscle cramps.
However, there is a growing school of thought that pain may actually be due to changes in the way pain signals are communicated through the central nervous system — more similar to people with chronic pain.
A research team led by Dr Monty Silverdale (see video below) are currently conducting the largest and most detailed study of pain in Parkinson’s to understand more about why people experience pain which they hope will provide vital knowledge that will lead to better treatments.
Swallowing
Swallowing occurs on average about 1000 times a day. But as Parkinson’s progresses, some people with the condition experience swallowing problems due to how the condition affects the control of their throat muscles.
Current approaches for tackling these problems are limited and include speech and language therapy and changing the consistency or texture of food.
What research is being done?
Researchers at the University of Manchester are exploring new techniques to treat swallowing difficulties. These include using different types of electrical pulse to stimulate the area of the brain that controls swallowing, and stimulating the throat muscles directly with an electrical current.
Hear more about this research by watching the video below:
Anxiety
Some people with Parkinson’s may experience anxiety including feelings of unease, worry and fear, these symptoms can be related to changes in the brain caused by Parkinson’s.
When anxiety continues for long periods of time it may affect people’s ability to carry out everyday activities. People affected by Parkinson’s identified tackling symptoms of stress and anxiety as the second most important priority for improving life.
What research is being done?
Drug treatments aimed at tackling these symptoms are often not as effective in people with Parkinson’s so we really need new ways to manage these symptoms as they can have a huge impact on quality of life.
Researchers are now investigating whether non-drug therapies that have shown promise in other types of anxiety may help people with Parkinson’s to cope with these issues.
- A team based at City University London are currently exploring whether mindfulness therapy could be beneficial.
- Another team, based at Kings College London, are testing another approach which uses computer-based exercises to understand and potentially even reduce anxiety. Find out more.
What have we missed?
We haven’t been able to cover every aspect of Parkinson’s in this blog, so if we’ve missed something that’s really important to you that you’d like us to blog about in future please let us know in the comments below.
Join us!
It’s vital that people affected by Parkinson’s are involved in research — helping to set the priorities, shape the questions and find the answers to problems like those highlighted in this blog.
Join the Research Support Network and get stuck in.
